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West Virginia Income Maintenance Manual Chapter 1

West Virginia Income Maintenance Manual Page 185 Chapter 1 Application/Redetermination Process

1.18.7.B Spenddown The date of eligibility is the day on which the client incurs medical expenses which bring the spenddown amount to $0. This date may be backdated up to three months prior to the month of application, when all eligibility requirements were met, and the client has medical expenses for which he seeks payment. 1.18.8 REDETERMINATION 1.18.8.A Non-Spenddown 1.18.8.A.1 The Redetermination List Non-Spenddown AGs are redetermined in the sixth month of the POC. The six-month period begins with the month of application. The date of the next redetermination is automatically coded in the eligibility system. The eligibility system alerts the Worker when a redetermination is due and sends a redetermination form to the client. 1.18.8.A.2 Completion of Redetermination When the redetermination is completed and the AG remains eligible, the new POC begins the month immediately following the month of the redetermination. NOTE: Although eligibility begins on the date that medical bills bring the spenddown amount to $0, expenses incurred on that date which are used to meet the spenddown, as indicated by the Worker in the eligibility system are not paid by Medicaid.

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Page 218

Official source

West Virginia Income Maintenance Manual Chapter 1

West Virginia Income Maintenance Manual Page 185 Chapter 1 Application/Redetermination Process

1.18.7.B Spenddown The date of eligibility is the day on which the client incurs medical expenses which bring the spenddown amount to $0. This date may be backdated up to three months prior to the month of application, when all eligibility requirements were met, and the client has medical expenses for which he seeks payment. 1.18.8 REDETERMINATION 1.18.8.A Non-Spenddown 1.18.8.A.1 The Redetermination List Non-Spenddown AGs are redetermined in the sixth month of the POC. The six-month period begins with the month of application. The date of the next redetermination is automatically coded in the eligibility system. The eligibility system alerts the Worker when a redetermination is due and sends a redetermination form to the client. 1.18.8.A.2 Completion of Redetermination When the redetermination is completed and the AG remains eligible, the new POC begins the month immediately following the month of the redetermination. NOTE: Although eligibility begins on the date that medical bills bring the spenddown amount to $0, expenses incurred on that date which are used to meet the spenddown, as indicated by the Worker in the eligibility system are not paid by Medicaid.